2021 Volume 17 Issue 1 Pages 30-37
Aim: Due to the tendency of later childbearing, ever-larger number of women are at risk of developing pelvic organ prolapse (POP) over a short period after delivery. To review the general trends of POP following childbirth, we conducted a retrospective hospital record survey.
Methods: Subjects were consecutive 31 paras who newly visited our department since January 2018, seeking surgical repair of a POP that had developed before the age of 50. The electronic hospital record was reviewed for physical assessment description and ultrasound image data.
Results: The mean age and BH was 46.5 years and 1.7 times, respectively. The average age of POP onset was 38.6 years.
The prevalence of retroverted uterus was significantly higher than in the general population. Ultrasound imaging revealed substantial damage to either or both of the levator ani and the external anal sphincter. Other frequent findings were, abnormal levator ani function and/or enlargement of the levator hiatus, funnel-shape bladder neck enlargement, and urethral hypermobility.
Conclusion: Dynamic translabial ultrasonography with a convex probe is highly useful for evaluating levator ani function, bladder neck deformity and urethral mobility. 3D introital ultrasonography using a transvaginal probe is a reliable tool for detecting levator ani muscle and anal sphincter damages. Our study suggests that retroverted uterus, obstetric trauma to the levator ani muscle and the external anal sphincter, reduced contractility of the levator ani muscle, as detected by physical assessment and ultrasound imaging, are associated with the development of POP at a younger age.
